Authors: Srivastava K, Gupta SC, Kaushal SK, Chaturvedi M, Gurnani KCInstitute’s name: S.N. Medical College & Hospital Agra, U.P.Presented By: Kajal Srivastava, JR-3, Deptt. of SPM

IntroductionThe elderly are a precious asset for any country.

With rich experience and wisdom, they contribute their might for sustenance and progress of the nation.

Their special health and economic issues differ from those of the general population.

The increasing number of older people in Indian society has been well perceived. While population ageing is a success story of socioeconomic development and good public health practice, it has also lead to economic and social crisis due to crumbling support system, with increased demand for health and welfare services.

The SRS estimates for the year 2003 were that 7.2% of total population were 60 plus in India.

The old age people suffer from health problems which are of mainly two types i.e. medical and psychosocial.

ObjectivesIn light of above facts, the present study was

conducted with the objective To assess the morbidity pattern of elderly and To make comparisons among urban and

urban slum of Agra district.

A cross sectional study was conducted in the department of Social & preventive medicine, S. N. Medical College, Agra on the persons aged 60 years and above living in the urban areas of Agra district.

Many studies have been conducted on elderly in different parts of our country, which report different prevalence of morbidities in their field practice area. SPS Bhatia et al found 86.1% morbidity load, likewise Parray SH et al reported 89% prevalence rate. In Uttar Pradesh Gupta SC et al observed 79%, Ravishankar et al found 88.8% and Goel PK et al reported 74.2% morbidity load during their study period. Psychosocial problems studied by Rahul Prakash et al observed 42% prevalence.

Material and Methods

The prevalence of psychosocial problem which was lower was taken as the basis for sample size calculation The prevalence of psychosocial problem which was lower was taken as the basis for sample size calculation. Sample size was calculated by using the prevalence as 42%, with a relative precision (d) as 15% and a confidence level of 95%, using the formula: 4pq/(15%of p )2. So sample size obtained was 245.

As we compared the results in urban & urban slums a minimum sample of 245 aged persons from both areas was taken to draw the valid conclusions. Since urban slums constitute 51% and urban areas 49% population, therefore 245 aged persons from urban & 255 from urban slums were taken. Thus total sample size was came out to be 500.

Multistage simple random sampling technique was adopted.

Each individual above the age of 60 was interviewed. Information regarding history of current and past illness were taken and general examination was performed.

Prescription of doctor regarding illness was also checked and was taken in to consideration for classifying illnesses.

The information was collected on pre-designed and pre-tested schedule. The data collected were compiled and analyzed with the help of MS- excel and SPSS 17 & Epi info software and following observations were made.

PREVALENCE OF MORBIDITY IN STUDY POPULATION

Persons with morbidity

Urban Urban Slum Total

No. % No. % No. %

Yes 205 83.7 227 89.0 432 86.4

No 40 16.3 28 11.0 68 13.6

Total 245 100.0 255 100.0 500 100.0

Test of Significance- X 2(1)= 3.04: p>0.05 Urban Vs Urban Slum

Prevalence of common morbiditiesS.No.

Morbidity Urban Urban Slum

Total Ztest

No. % No. % No. %

1. Anaemia 33 13.47 98 38.43 131 26.20 5.08*

2. Cataract 46 18.04 76 29.80 122 24.40 1.52

3. Hypertension

67 27.35 44 17.96 111 22.20 1.62

4. Arthritis 49 20.0 62 24.31 111 22.20 0.79

5. Hearing impairments

28 11.43 55 21.57 83 16.60 1.83

6. Dental caries

14 5.71 61 23.92 75 15.00 3.33*

7. Chronic pain

13 5.31 41 16.07 72 14.40 1.87

8. COPD 26 10.61 45 17.65 71 14.20 0.85

System wise classification of the morbidities

System Urban Urban slum Total (n=500) Z test

No. % No. % No. %

Cardiovascular System 113 46.1 145 56.8 258 51.6 1.8

Musculoskeletal system 64 26.1 122 47.8 186 37.2 3.1*

Visual Disorders 46 18.8 133 52.2 179 35.8 4.6*

ENT 40 16.3 43 16.9 83 16.6 0.1

Dental problem 14 5.7 61 23.9 75 15.0 3.3*

Respiratory System 26 1.1 43 16.9 69 13.8 1.9

GIT 39 15.9 12 4.7 51 10.2 1.8

Genitourinary system 18 7.3 23 9.0 41 8.2 0.2

Endocrine system 32 13.1 6 2.4 38 7.6 1.7

Skin 14 5.7 17 6.7 31 6.2 0.2

Nervous system 7 2.9 2 0.8 9 1.8 0.3

Result and Discussion

Prevalence of morbidity was found to be 86.1% in our study. Similar higher percentages was also reported by Bhatia et al. (86.1%) and Parry SH et al. (83.9%).

Diseases of cardiovascular system was found to dominate the community (51.6%), among CVS problems anaemia(26.2%) and hypertension (22.2%) was most common. Different studies reported prevalence of hypertension as 11.25%and 33% .

Diseases of Musculoskeletal system constituted 37.2% of illnesses . In our study higher prevalence was seen in slum dwellers (47.84%) compared to urban area (26.12%). Arthritis was the major musculoskeletal problem contributing to 22.2% in our study group. Similar results were reported by Prakash R et al (14.8%).

Ocular disorder constitute 35.80% in our study, which is similar as found by RB Gaurav et al as 32.8%, Parry SH et al (39%) and Naveen KH et al (36%). Cataract was most common ocular disability and was higher in slum population (29.80%).

Among dental problem dental caries was sole problem found in study population.

Poor hygiene was supposed to be responsible for more caries in slum area (23.92%) compared to urban (5.71%). Khokhar A et al seen 90.62 % suffered from dental problems.

Major ENT problem was hearing impairments contributing to 16.60% load in urban aged and was found to be more among slum population(21.57%). Its prevalence was found as 20% by Naveen KH et al.

13.8% urban aged suffered from Respiratory system problems. Among respiratory problem chronic obstructive pulmonary diseases was most common(14.20%). Chandwani et al1 reported bronchial asthma as 12.2%.

ConclusionStrategies are required to bring about an

improvement in their quality of life.

The need of the hour is to set up geriatric wards that would fulfill the specific needs of the geriatric population by provision of distinct OPD services.

Providing screening services as well as curative and rehabilitative services and convalescent homes to provide long-term care, which may be a part of designated hospitals, is also a priority.

Thank You